J Korean Soc Spine Surg.  1998 Nov;5(2):224-230.

Treatment of King Type V Adolescent Idiopathic Scoliosis(AIS) by Separate Curve Derotation with Segmental Pedicle Screw Fixation

• Suk SI
• Kim JH
• Kim WJ
• Lee SM
• Liu Y
• Lee CS
• Jong ER
• Ko JG

Abstract

STUDY DESIGN: This is a retrospective study.
OBJECTIVES
To verify the efficacy of the separate curve derotation technique by segmental pedicle screw fixation in King type V adolescent idiopathic scoliosis(AIS). SUMMARY OF BACKGROUND DATA: King type V AIS is commonly treated by fusion of both the upper and the lower thoracic curve. However, both curves fusion often leads to undesirable shoulder asymmetry by relative overcorrection of the more flexible lower thoracic curve.
METHODS
Fourteen patients subjected to both curve fusion with segmental pedicle screw fixation by separate curve derotation were analyzed after a minimum follow-up of 2 years. The group comprised 11 females and 3 males with a mean age of 15.9 years. All patients had upper left thoracic and lower right thoracic curve pattern. The upper thoracic curve was 46.2+/-10.3degrees with a flexibility of 39.6%. The lower thoracic curve was 54.3+/-14.5degrees with a flexibility of 59.1%. Preoperatively, shoulder was level in 4, left elevated in 8 and right elevated in 2 patients.
RESULTS
At the final follow up, the upper thoracic curve was corrected to 21.5+/-8.7degrees showing a correction of 52.8%. The lower thoracic curve was corrected to 20.0+/-10.6degrees showing a correction of 63.5%. All the patients had improvement of shoulder height difference and trunk balance clinically and radiologically.
CONCLUSIONS
Segmental pedicle screw fixation and separate derogation is an effective method of restoring shoulder symmetry and maintainig trunk balance in King type V AIS.

MeSH Terms

Adolescent*
Female
Follow-Up Studies
Humans
Male
Pliability
Retrospective Studies
Shoulder